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Early detection of skin cancer is essential in order to obtain an improved prognosis. Clinicians need more objective and non-invasive examination methods to support their decision whether to biopsy or not tumoral lesions. These may include several imaging techniques such as dermoscopy, videodermoscopy, also known as sequential digital dermoscopy (SDD), computer-aided diagnosis (CAD), total body photography, imaging and high-frequency ultrasonography (HFUS), reflectance confocal microscopy, multiphoton tomography, electrical impedance spectroscopy, Raman spectroscopy, stepwise two-photon-laser spectroscopy and quantitative dynamic infrared. This review summarizes the current developments in the field of melanocytic lesions, such as naevi and basal cell carcinoma (BCC) imaging techniques. The aim was to collect and analyze data concerning types, indications, advantages and disadvantages of modern imaging techniques for in vivo skin tumor diagnosis. Two main methods were focused on, namely videodermoscopy and HFUS, which can be included in daily dermatologists' practice. In skin tumors HFUS allows the assessment of tumoral lesions with depth smaller than 1.5 cm, being described a correlation between ultrasonographic depth and the histologic index. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) and chronic kidney disease (CKD) are frequently interconnected and their association leads to an exponential increase in the risk of both fatal and non-fatal events. In addition, the burden of arrhythmias in CKD patients is increased. On the other hand, the presence of CKD is an important factor that influences the decision to pursue cardiac device therapy. Data on CKD patients with device therapy are scarce and mostly derives from observational studies and case reports. Cardiac resynchronization therapy (CRT) is associated with decreased mortality, reduced heart failure symptoms, and improved renal function in early stages of CKD. Implantable cardioverter defibrillators (ICDs) are associated with a significant reduction in the mortality of CKD patients only for the secondary prevention of sudden cardiac death. Cardiac resynchronization therapy with defibrillator (CRT-D) is preferred in patients who meet the established criteria. The need for cardiac pacing is increased three-fold in dialysis patients. CKD is an independent risk factor for infections associated with cardiac devices. [ABSTRACT FROM AUTHOR]

A tracheoesophageal fistula (TEF) is a communication between the trachea and esophagus that is acquired or congenital. Congenital TEF, without other conditions like esophageal atresia, is usually diagnosed after birth or during infancy, as the baby will develop respiratory symptomatology, mostly severe, due to fluid/food aspiration in the trachea. In adults, TEFs can be caused by malignant conditions, blunt trauma, iatrogenic injury, prolonged mechanical ventilation and excessive inflation pressure of the endotracheal tube. We report a male patient of 86 years of age who presented at the "St. Spiridon" Emergency County Hospital in January 2022, accusing breathing difficulty, productive cough and occasional stabbing pain in the posterior thorax, within the previous week. Clinical exam was typical for pneumonia, but since the patient mentioned coughing episodes during eating/drinking since December 2021, together with a history of general anesthesia for abdominal surgery in mid-November 2021, a CT scan was performed. It confirmed a TEF of 7/16 mm (transverse/cranio-caudal) in size, located at the level of T2 vertebral body. The particularity of the case resides in the uncertain etiology of the fistula. If this patient had a clear iatrogenic injury, aspiration pneumonia should have occurred within days after the intubation event. However, after the surgery the patient was fine and discharged home without any symptomatology relevant for TEF. Only after one month, he started experiencing coughing during eating, that leads us to the assumption that he might have been born with a very small and asymptomatic tracheoesophageal defect, and the intubation for general anesthesia, even if done in a correct manner, represented a trigger event which led to development of a TEF. There are very few cases reported in literature with adult patients presenting a minor structural defect that remained unnoticed for a very long time. [ABSTRACT FROM AUTHOR]

Background: The incidence of hypoxaemia related to airway management is still a matter of concern. Our aim was to determine the factors that contribute to hypoxaemia during induction of anaesthesia after a standardised preoxygenation procedure.Methods: The study was a multicentre and prospective observational trial. It evaluated the incidence of hypoxaemia at induction of anaesthesia in adult patients. The primary endpoint was the incidence of hypoxaemia defined as pulse oximetry of arterial oxyhaemoglobin saturation (SpO2) <95%.Results: Of 2398 patients, hypoxaemia was observed in 158 (6.6%). We identified five preoperative independent risk factors: chronic obstructive pulmonary disease, hypertension, anticipated difficult mask ventilation and difficult tracheal intubation, and emergency surgery. There were also three pre-induction independent risk factors: difficult preoxygenation, difficult mask ventilation, and difficult tracheal intubation. We found a high negative predictive value of preoperative risk factors for difficult mask ventilation of 0.96 (0.95-0.96), and for difficult tracheal intubation (0.95 [0.94-0.96]). A total of 723 patients (30%) experienced difficult preoxygenation (FeO2 <90% at the end of preoxygenation). Male sex, chronic obstructive pulmonary disease, hypertension, emergency surgery, and predictable difficult mask ventilation were independent patient risk factors for difficult preoxygenation.Conclusions: Difficult mask ventilation and difficult tracheal intubation are risk factors for hypoxaemia at induction of general anaesthesia. Difficult preoxygenation was observed in 30% of patients and was also identified as a risk factor for hypoxaemia. This suggests that techniques improving preoxygenation should be implemented in daily practice. [ABSTRACT FROM AUTHOR]

Objectives – Obstructive sleep apnea (OSA) has been linked to arterial stiffness and increased cardiovascular risk. The aim of this study was to analyse the relationship between OSA severity, arterial stiffness and clinico-biological parameters in moderate-severe OSA subjects. Methods – We assessed arterial stiffness using the Arteriograph (Tensiomed, Hungary) in 41 patients with newly diagnosed moderate-severe OSA prior to the initiation of positive pressure therapy. Results – Our study included 18 and 23 patients with moderate and severe OSA, respectively. Mean apnea hypopnea index (AHI) 40.69 events/h. Desaturation index, minimum nocturnal O2 saturation, erythrocyte sedimentation rate (ESR), ejection duration and return time were significantly different between the two subgroups. AHI was correlated with the other OSA severity parameters but also with pulse wave velocity (PWV), C reactive protein and ESR. PWV was negatively correlated with magnesium. Mean nocturnal oxygen saturation, age, body mass index and abdominal circumference did not significantly differ between the moderate and severe OSA subgroups. Conclusions – PWV and inflammation markers are correlated with OSA severity. We also found a negative correlation between serum magnesium and PWV in moderate-severe OSA patients. [ABSTRACT FROM AUTHOR]

Patients undergoing ablation for atrial fibrillation may be at increased risk of developing gastroesophageal reflux disease. We prospectively studied the presence of symptomatic gastroesophageal reflux disease in naïve patients who underwent atrial fibrillation ablation. Methods: The presence of typical symptoms suggestive of gastroesophageal reflux disease was clinically assessed by the gastroenterologist at baseline and at 3 months after ablation. In addition to that, all patients underwent upper gastrointestinal endoscopy. Results: Seventy-five patients were included in two groups: 46 patients who underwent atrial fibrillation ablation (study group) and 29 patients without ablation (control group). Patients with atrial fibrillation ablation were younger (57.76 ± 7.66 years versus 67.81 ± 8.52 years; p = 0.001), predominantly male (62.2% versus 33.3%; p = 0.030) and with higher body mass index (28.96 ± 3.12 kg/m2 versus 26.81 ± 5.19 kg/m2; p = 0.046). At three months after the ablation, in the study and control groups, there were 88.9% and 57.1% patients in sinus rhythm, respectively, (p = 0.009). Symptomatic gastroesophageal reflux disease was not more frequent in the study group (42.2% versus 61.9%; p = 0.220). There was no difference in terms of sinus rhythm prevalence in patients with versus without symptomatic gastroesophageal reflux disease (89.5% versus 88.5%; p = 0.709). Conclusion: In this small prospective study, typical symptoms suggestive of gastroesophageal reflux disease were not more frequent three months following atrial fibrillation ablation. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is associated with increased cardiovascular risk, sedentarism, depression, anxiety and impaired quality of life. The long-term effectiveness of positive airway pressure (PAP) is insufficiently studied and limited by poor patient compliance. The aim of this pilot prospective cohort study was to evaluate long-term adherence in overweight patients with moderate–severe OSA and hypertension and to analyze changes in weight, sleepiness and quality of life. We performed a prospective study that included overweight patients with moderate–severe OSA and hypertension who had not undergone previous PAP therapy. All subjects received a standard physical examination, education regarding lifestyle changes and free PAP therapy for 2 months. After five years, the patients were invited to participate in a telephone-based interview regarding PAP compliance and completed standard questionnaires assessing adherence to medication, physical activity, diet, anxiety and quality of life (QoL). Only 39.58% of the patients were adherent to PAP 5 years (58.42 ± 3.70 months) after being diagnosed with moderate–severe OSA. Long-term PAP use results in sustained weight loss; improved blood pressure control, sleepiness and QOL; and lower anxiety and depression scores. PAP compliance was not associated with a higher level of daily physical activity or a healthier diet. [ABSTRACT FROM AUTHOR]

Nontrombotic pulmonary embolism represents the embolization of different types of materials (cells, organisms, gas, foreign material) into pulmonary circulation. The disease is uncommon, and clinical presentation together with laboratory findings are nonspecific. Its pathology is usually misdiagnosed based on imaging findings as pulmonary thromboembolism, but the correct diagnosis is essential because different therapeutic approaches are required. In this context, knowledge of the risk factors associated with nontrombotic pulmonary embolism and specific clinical symptoms is fundamental. Our objective was to discuss the specific features of the most common etiologies of nontrombotic pulmonary embolism, gas, fat, amniotic fluid, sepsis and tumors, to provide assistance for a rapid and correct diagnosis. Because the most common etiologies are iatrogenic, knowledge of the risk factors could be an important tool for prevention or rapid treatment if the disease develops during different procedures. The diagnosis of nontrombotic pulmonary embolisms represent a laborious challenge, and endeavors should be made to prevent development and increase awareness of this disease. [ABSTRACT FROM AUTHOR]

The recurrent artery of Heubner (RAH) is a medial lenticulostriate artery, whose variable features such as origin, number, course, collateral and terminal branches give rise to many studies which reveal its anatomical variations. During the dissection of a formalin-fixed human brain, focused on circle of Willis, we discover a unique vascular pattern of the RAH. We identified the presence of two recurrent arteries on the right side and three on the left side. Moreover, the left recurrent arteries have a rare course, they being located inferiorly by the first segment (A1) of the anterior cerebral artery (ACA). Another particular aspect is represented by the relationship with the other vascular structures: the left anterior RAH has a similar course with the frontoorbital artery, the left inferior RAH has a terminal branch which surrounding the A1 segment of ACA, and the left middle RAH come out into the sylvian fissure. On the right side it notices one RAH with a long extracerebral course. This case shows a complex and rare vascular pattern with a major clinical importance because, even if the RAH is a small artery, its injury can cause important neurological deficits. [ABSTRACT FROM AUTHOR]

Background. Aortic dissection is a life-threatening disorder and up to 20% of patients die before receiving medical care. Marfan syndrome is noted in 5-9% of individuals who suffer from aortic dissection. Case presentation. We present the case of a 53 years old woman, with undiagnosed Marfan syndrome, addressed to our clinic complaining about thoracolumbar pain appeared 4 days ago, after a trauma. According to the revised Ghent criteria for the diagnostic of Marfan syndrome she had a positive family history and more than 7 points of systemic findings. She was also diagnosed with extensive aortic dissection and right pneumothorax. Because of the cachexia and important scoliosis, the operative and post operative risk was high and we decided a medical management. She remained haemodynamically stable, with a false lumen partially trombosed, and was discharged home after 23 days. Discussion. The particularity of our case represent the diagnostic of Marfan syndrome after the appearance of a vital risk vascular complication - aortic dissection, the emergency surgical intervention being limited by the clinical and prognostical particularities of these two comorbidities. Conclusion. Aortic dissection in Marfan syndrome represents a diagnostic and therapeutic challenge for interdisciplinary practitioner physicians. [ABSTRACT FROM AUTHOR]

Abstract: The paper presents the last of our QENS and INS measurements on triglycine sulphate DTGS (ND3) at NEAT – BENSC neutron spectrometer. Using an energy window of 0.093meV we have completed the information obtained in our previous measurements that were carried on non-deuterated TGS. By replacing the protons from amino groups of TGS with deuterons we have been able to observe the dynamical changes in the QENS pattern. The quasielastic line broadening in this case is mainly due to the flip jump diffusion motion of the protons which belong to CH2 group of the GI glycine molecule in DTGS. The residence time associated to this motion is about 4.2ps. The second part of the paper is devoted to lattice phonons and internal molecular normal modes. The peaks observed in the generalized density of states were compared with optical spectroscopy data. The agreement is good. [Copyright &y& Elsevier]

Cardiovascular disease and chronic kidney disease are frequently inter‐connected and this association leads to an exponential growth of cardiovascular risk. This risk is currently underestimated by the existing algorithms and there is a constant need for new markers to predict adverse outcomes in this special population. In general population left atrial strain has emerged as an important tool for both the diagnosis and prognostic stratification, but data regarding its role in chronic kidney disease patients is scarce. The purpose of this review is to summarize the current evidence regarding this matter. Left atrial size and function mirror the duration and severity of increased left ventricular filling pressures. Increased left atrial volume index and impaired left atrial strain parameters are independent predictors for adverse cardiovascular events. Left atrial strain is impaired before changes in volume appear, thus being able to predict both diastolic and systolic function in chronic kidney disease patients. Finally, left atrial strain can identify renal patients with impaired exercise capacity and this could have clinical applications in the rehabilitation of this patients. [ABSTRACT FROM AUTHOR]

Incomplete right bundle branch block (IRBBB), an entity undefined by a general consensus, can express a large pallet of both benign and pathological patterns. IRBBB is a common electrocardiogram (ECG) finding at all ages, more frequent in men and athletes. Usually, IRBBB does not need further evaluation; however, if abnormalities are found on the clinical exam, heart disease should be excluded. The RSR' pattern and a QRS width below 100 ms define the crista supraventricularis (CSV) pattern. CSV is a right ventricular crest, one of the last structures to be depolarized by the Purkinje network. CSV pattern might result from posterior apex deviation, subpulmonic area delay, or late CSV activation. IRBBB can appear because of higher placement of electrodes V1 and V2 and pectus excavatum, in which P wave is negative, or in athletes, considered a benign pattern unless family history, symptoms, or left ventricular hypertrophy. It is necessary to differentiate IRBBB from pathological patterns such as type-2 Brugada ECG pattern, right ventricular enlargement, arrhythmogenic right ventricular cardiomyopathy, ventricular preexcitation--Wolf-Parkinson-White syndrome, and hyperkalemia. Examiners should be particularly alert to the splitting of the second heart sound because RBBB is a common finding in ostium secundum atrial septal defect. Therefore, clinicians need to be familiar with this ECG finding, which is not always a benign condition. [ABSTRACT FROM AUTHOR]

Hypereosinophilic syndrome encompasses a heterogenous group of non-hematologic and hematologic disorders defined as peripheral blood eosinophilia >1500/mm3 persisting more than 6 months and eosinophilic end organ complications1,2. Löeffler endocarditis (LE) is the most common cardiac manifestation of the hypereosinophilic syndrome (HES) and represents an acute form of primary restrictive cardiomyopathy?. We report the case of a 74 years-old woman with symptoms related to congestive heart failure and weight loss. At admission the patient had tachycardia and a grade 2/6 systolic mitral murmur. Laboratory findings revealed eosinophilia, hepatocytolysis syndrome and dyslipidemia. The electrocardiogram (ECG) showed non-specific ST-segment and T wave abnormalities. The echocardiography revealed left ventricular apical thrombus and entrapment of chordae tendineae with restricted motion of mitral leaflets leading to mitral regurgitation. The diagnosis of myocarditis was confirmed by the cardiac magnetic resonance imaging which showed the presence of a left ventricular mass with low signal on steady-state free precession imaging and diffuse circumferential subendocardial late gadolinium enhancement (LGE). When discussing the etiology of the HES the following were taken into consideration: hematologic, reactive or secondary disorders. This case is distinguished by diagnosis in an elderly woman and good response to corticosteroid therapy. [ABSTRACT FROM AUTHOR]

Objectives - To provide preliminary data on practice of stress perfusion cardiovascular magnetic resonance (CMR) in a single center in Romania. Methods - We retrospectively reviewed the clinical files and CMR reports of patients who underwent stress perfusion CMR in our institution between January 2018 and December 2020. Results - A total of 1036 patients underwent CMR examinations during this period in our institution. Of these, 120 patients had stress perfusion CMR. The most common indication was the assessment of myocardial ischaemia in patients with established coronary artery disease (CAD) (77 patients, 64.16%), with either a history of myocardial infarction or previous coronary revascularization, or with intermediate lesions on invasive coronary angiography (ICA). The other indications consisted in detection of ischaemia in patients with suspected CAD (36 patients, 30%), characterization of the substrate of ventricular arrhythmia (5 patients, 4.16%) and assessment of the etiology of dilated cardiomyopathy (DCM) (4 patients, 3.33%). All patients had vasodilator stress with adenosine and an adequate stress response was obtained in 113 patients (94.16%). There were 21 patients (18.58%) with an abnormal stress test and patients with intermediate lesions on ICA had the highest prevalence of positive reports (24.32%). Sixty-three patients had myocardial fibrosis (52.5%): 49 patients (40.83%) had subendocardial (ischaemic) scars, while 14 patients (11.66%) had non-ischaemic scars. There were no serious adverse events related to the procedure. Conclusions - This is the first report in Romania on the use of stress perfusion CMR in clinical practice. We report our experience on stress efficiency, acquisition protocol, artifacts, prevalence of positive tests and safety. Most stress CMRs were requested in patients with established CAD. [ABSTRACT FROM AUTHOR]

A 45-year-old male, hypertensive and obese presented with a 3-months history of short episodes of intermittent palpitations. Clinical examination was unremarkable; however, the electrocardiogram documented major right bundle branch block and the presence of fragmented QRS in all precordial leads. His echocardiography documented a dilated left ventricle, with mild systolic dysfunction and moderate biventricular reduction of the global longitudinal strain. On angiography, the epicardial coronary arteries were normal. A cardiac MRI revealed diffuse transmural fibrotic lesions with non-ischemic pattern of the ventricles, suggestive of chronic myocarditis. The electrophysiological study induced two ventricular tachycardia morphologies which were ablated and an ICD for sudden cardiac death primary prevention was implanted. Fortunately, at 6 months follow-up our patient had no ICD therapies and reported an alleviation of symptoms. [ABSTRACT FROM AUTHOR]

Treatment of patients with immune thrombocytopenic purpura (ITP) associated with recurrent venous and arterial thrombosis can represent a major challenge. We present the rare case of a 56-year-old female who was first diagnosed with severe ITP at the age of 36. She required corticosteroid therapy and splenectomy in evolution. However, in the last three years she had several episodes of recurrent venous thromboembolism for which she required different anticoagulant therapies despite severe thrombocythemia. The patient also developed acute myocardial infarction treated by primary percutaneous coronary intervention that was complicated with acute intrastent thrombosis. Thus, maximal antiplatelet therapy was mandatory. For ITP, the patient received intravenous steroids, platelet transfusion as well as eltrombopag. Moreover, the patient also suffered from a haemorrhagic uterine fibroma that required surgery. Thus, a close multidisciplinary approach was needed for the successful treatment of this patient. [ABSTRACT FROM AUTHOR]

Objectives - The European Cardiac Resynchronization Therapy Survey II is the second CRT survey of the Heart Failure Association and European Heart Rhythm Association designed to observe implantation and follow-up practices across European countries. These data allow, for the first time, a valuable insight on CRT implantation strategies for Romanian patients. Methods - A total of 214 patients undergoing CRT-P/CRT-D implantations in 7 Romanian implantation centers were included in the survey. A one-time online case report form including data on implantation indication and procedure was completed for each implantation attempt. Results - Romanian patients were younger than the other European patients (p<0.001), had more severe symptoms of heart failure, lower ejection fraction and wider QRS complexes. More than half of the patients had non-ischemic cardiomyopathy. Most of the patients were in sinus rhythm, with a median intrinsic QRS duration of 163±24 ms. Echocardiography was the imaging method most often used and the median left ventricular ejection fraction was 24.9±8%. In comparison with other European countries, CRT-D devices and multipolar ventricular leads were more rarely implanted (p<0.001). Conclusions - In Romania indications regarding CRT implantation follow the most recent ESC guidelines, but the ratio of CRT-D devices in Romania is lower than in the other European countries and patients with more severe heart failure receive CRT. CRT should be considered earlier in heart failure patients in order to improve outcome. [ABSTRACT FROM AUTHOR]

Purpose. Nontraditional cardiovascular risk factors as apolipoprotein A (ApoA), apolipoprotein B (ApoB), and the proprotein convertase subtilisin/kexin type 9 (PCSK9) increase the prevalence of cardiovascular mortality in chronic kidney disease (CKD) or in end-stage renal disease (ESRD) through quantitative alterations. This review is aimed at establishing the biomarker (ApoA, ApoB, and PCSK9) level variations in uremic patients, to identify the studies showing the association between these biomarkers and the development of cardiovascular events and to depict the therapeutic options to reduce cardiovascular risk in CKD and ESRD patients. Methods. We searched the electronic database of PubMed, Scopus, EBSCO, and Cochrane CENTRAL for studies evaluating apolipoproteins and PCSK9 in CKD and ESRD. Randomized controlled trials, observational studies (including case-control, prospective or retrospective cohort), and reviews/meta-analysis were included if reference was made to those keys and cardiovascular outcomes in CKD/ESRD. Results. 18 studies met inclusion criteria. Serum ApoA-I has been significantly associated with the development of new cardiovascular event and with cardiovascular mortality in ESRD patients. ApoA-IV level was independently associated with maximum carotid intima-media thickness (cIMT) and was a predictor for sudden cardiac death. The ApoB/ApoA-I ratio represents a strong predictor for coronary artery calcifications, cardiovascular mortality, and myocardial infarction in CKD/ESRD. Plasma levels of PCSK9 were not associated with cardiovascular events in CKD patients. Conclusions. Although the "dyslipidemic status" in CKD/ESRD is not clearly depicted, due to different research findings, ApoA-I, ApoA-IV, and ApoB/ApoA-I ratio could be predictors of cardiovascular risk. Serum PCSK9 levels were not associated with the cardiovascular events in patients with CKD/ESRD. Probably in the future, the treatment of dyslipidemia in CKD/ESRD will be aimed at discovering new effective therapies on the action of these biomarkers. [ABSTRACT FROM AUTHOR]

Objective - Arterial hypertension is an important cardiovascular risk factor with destructive effects on the cardio-renal axis. Approximately 10% of the hypertensive population suffers from the secondary form of this pathology. Methods - We hereby present the case of a 47-year-old patient who was addressed to our clinic because of persistent high blood pressure values, despite medication compliance. Results - Laboratory findings revealed elevated creatinine and hypokalaemia. Transthoracic echocardiography revealed left ventricular hypertrophy, diastolic dysfunction and subclinical systolic dysfunction. The renal angiogram was normal. The aldosterone: renin ratio was elevated. The tomographic computer exam revealed the presence of two micronodules in the right adrenal gland. The diagnosis of primary hyperaldosteronism was established. After the association of an antialdosteronic agent, a better control of the tensional values was obtained. The patient was referred for the surgical treatment of the lesion. Conclusions - Primary hyperaldosteronism accounts for 5-10% of resistant hypertension cases, and unilateral adrenal adenomas are the second most common cause after bilateral idiopathic hyperplasia. When untreated, it is associated with an increased rate of arrhythmias, coronary artery disease, heart failure, stroke, proteinuria and renal dysfunction. The gold standard for the treatment of unilateral adenomas is surgical resection. [ABSTRACT FROM AUTHOR]

Background - The use of stress myocardial perfusion scintigraphy, Single-photon Emission Computed Tomography (SPECT), is nowadays revived in the evaluation of patients with suspected ischemic heart disease in order to indirectly assess blood fl ow and myocardial fl ow reserve. Aim of the study - To identify clinical, electrocardiographic (ECG) and echocardiographic features associated with SPECT abnormalities in myocardial perfusion. Materials and methods - We conducted an observational, prospective study, on 17 successively enrolled patients, 58.83% men, aged 35-79 years (57.47+/-13.18 years), admitted in a cardiology clinic of an academic, general, non-coronarography capable hospital, where every resource to identify and quantify myocardial ischemia must be used. The following data was collecting: cardiovascular risk factors, myocardial ischemia on ECG, echocardiographic quantification of cardiac chamber size and left ventricular ejection fraction (LVEF) and perfusion defects on stress myocardial SPECT. Results - Perfusion defects on 99mTc-MIBI SPECT were detected on the majority of patients (76.47%) while ECG was suggestive for ischemia in only 52.94% of the total included patients. There were no significant differences on the cardiovascular risk factors between the subgroup of patients with or without defects in myocardial perfusion SPECT. Anterior wall perfusion defects have been closely and directly correlated with right ventricular telediastolic diameter (p < 0.05, r = 0.730) and indirectly with BNP level (p < 0.01, r = -0.891) and inferior vena cava diameter (p < 0.05, r = -0.651). Lateral wall perfusion defects have been closely and directly correlated with creatinkinase, CK-MB level (p < 0.01, r = 0.711; p < 0.05, r = 0.607, respectively) and left ventricular posterior wall thickness (p < 0.01, r = 0.765) and indirectly with LVEF-echo (p < 0.051, r = -0.498). Inferior wall perfusion defects have been closely and directly correlated with BNP level (p < 0.05, r = 0.735) and indirectly with smoker status (p < 0.01, r = -0.683). Conclusion - We provide an early insight into SPECT parameters versus ECG/echocardiographic in patients with IHD assessed in Northeastern Romania, revealing some clinical, ECG and echocardiographic features, opening the perspectives for a larger prospective study. [ABSTRACT FROM AUTHOR]

Introduction - Systemic scleroderma is a rare, progressive, autoimmune disease, with multi organ implications, which may affect the heart, more frequent in the diffuse form (32%) than in a localized one (23%). The ventricular arrhythmias have a negative impact on prognosis and global mortality of the patients with scleroderma. Case report - Female patient, 39 years old, diagnosed with systemic scleroderma, implanted with a cardiac defibrillator (ICD) for sustained ventricular tachycardia (VT), treated by radiofrequency ablation (RFCA), in another center in 2012, was admitted in our center in November 2014, for numerous syncope and ICD therapies (20/4 days), despite Amiodarone treatment. EKG is suggestive for VT with right ventricle (RV), posterolateral region origin. The patient was submitted to an electrophysiological study. A 3D voltage cartography of the RV was done confirming the presence of extended basal fi brosis, with detection of abnormal potentials across the area. Radiofrequency applications were made at the borderline zone in order to isolate slow diastolic scar potentials until non-inducibility of any sustained tachycardia. During the next 40 months the patient remained asymptomatic, with an improved psychological status, without ICD therapies, under 100 mg Amiodarone. Conclusions - Radiofrequency catheter ablation can be an extremely helpful tool in the management of ventricular arrhythmias in patients with systemic scleroderma, at long term, especially in case of electrical storm. The arrhythmia freedom can improve the quality of life and survival, reducing the ICD therapies. [ABSTRACT FROM AUTHOR]

Skin ultrasonography is a non-ionizing imaging method useful in the in vivo study of skin lesions using ultrasound as a vector for imaging [1]. Plaque psoriasis is a chronic, immune-mediated disease which represents a global health problem. Our objective in this study was to evaluate ultrasonography as a tool for monitoring plaque psoriasis. In a prospective interventional analytic study we aimed to assess whether the first chronologically obtained change in psoriasis plaque assessment in monitored patients was a decrease in psoriasis plaque thickness and subepidermal hypoechoic band as compared to baseline values. The study was carried over a period of 8 weeks and included 50 patients diagnosed with psoriasis vulgaris in the Dermatology Clinic of the "Sfântul Spiridon" Emergency Hospital, Iasi, Romania. We assessed the evolution under topical (calcipotriol/betamethasone 50 micrograms/0.5mg/g gel or fluticasone propionate 0.05% cream in combination with lipolotion urea 10%) combined with systemic therapy (Etanercept) in severe forms of disease. Target lesions of psoriasis vulgaris were analysed by classical means (clinical examination) and by non-invasive imaging techniques such as high frequency ultrasonography (HFUS using Dermascan C® 20 MHz). The results showed that the first change obtained chronologically was the decrease in psoriasis plaque thickness and subepidermal hypoechoic band in the target plaque as compared to baseline values (i.e. at week 4 compared to week 0). After comparing the mean values of psoriasis plaque tegument thickness and hypoechoic subepidermal band thickness, we found that they decrease significantly both in week 4 compared to week 0 and in week 8 compared to week 4. Practical non‐invasive techniques to monitor plaque psoriasis progression and treatment are necessary. High frequency ultrasonographic examination allows an objective and reproducible measurement of skin thickness and is a useful technique for a non-invasive assessment of treatment efficacy in psoriasis. [ABSTRACT FROM AUTHOR]

Recoil spectrometry using heavy ions proposed in 1976 by L’Ecuyer has evolved into a universal IBA technique. Few years later an experimental setup for simultaneous light and medium heavy element detection including a compact ΔE(gas)–E r (solid) telescope, was developed at the Tandem accelerator of IFIN-HH. To increase the resolution, an integrated preamplifier was mounted close to the ionization chamber. The calibration procedure for the telescope and the software for the quantitative evaluation of the data are briefly presented. Recently, a 3 MV Tandetron accelerator has been installed and commissioned at the IFIN-HH. Among several ion-beam techniques for detection and depth profiling of hydrogen isotopes, Elastic Recoil Detection Analysis (ERDA) technique using a low energy 4 He beam, proposed by Doyle and Peercy, is particularly advantageous. By measuring simultaneously both the H or D recoiling at a forward angle and backscattered 4 He ions, a rather complete characterization of the sample can be achieved. Selected results from our investigations, obtained using these facilities, are presented. [ABSTRACT FROM AUTHOR]

When dealing with cultural heritage artifacts, the use of non-invasive and non-destructive analyses techniques is a must . Determination of the surface corrosion layers and coin composition is important both for identifying compounds that form different alloys (which can be considered support material for important objects, such as numismatic artifacts), and also for their conservation. The selection of analytical techniques is of great importance, as it is a strict condition that the structure of the artifacts should not be affected. The paper presents the archaeometallurgical study of seven silver coins, using several nuclear techniques (X-ray fluorescence – XRF, X-ray diffraction – XRD, Particle induced X-ray emission – PIXE) and optical microscopy. The study was performed using bulk methods and micro-area measurements in order to establish their composition, as well as the presence of corrosion products. This could, in turn, provide information in support of the categorization in genuine/possible forgery. From the analyzed set of samples, six can be surely categorized as genuine, while one raises some questions. A decisive conclusion cannot be drawn for one of the analyzed samples, but the scientific evidences suggest either a misstruck or a forgery approximately contemporary with the original issue of these coins. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is a major public health issue, due to its effect on the quality of life of patients and by the huge costs incurred in treating this disease. It is an irreversible process, characterized by the progressive loss of functional nephrons. CKD ultimately requires the support of renal function by dialysis or even renal transplantation. It has a multiple etiology, but the most common causes remain arterial hypertension and diabetes. High arterial blood pressure affects the target organs (kidneys) and this leads to a vicious circle involved in maintaining high blood pressure. Arterial hypertension is closely related to the renal pathology of CKD. The result of excessive activation of the renin angiotensin system (RAS) is increased angiotensin II (Ang II), which acts upon the systemic circulation and especially upon the kidneys. The outcome is high blood pressure and also the stimulation of proinflammatory and profibrotic effects in the kidneys. Collectively these ultimately lead to CKD. The aim of this review was to provide a brief overview of the pathophysiological associations between CKD, arterial hypertension, and Ang II. [ABSTRACT FROM AUTHOR]

In this work we present the deposition of amorphous SiC thin films by radiofrequency dual magnetron sputtering. The dependence of the deposited films properties over the discharges electrical power and the effect of hydrogenous species (H 2 and/or D 2 ) addition to main discharge gas (Ar) were investigated. Accurate elemental analysis of the samples, including detection of hydrogen and deuterium, was performed by ion beam analysis (IBA) techniques: RBS (Rutherford Backscattering Spectrometry) and ERDA (Elastic Recoil Detection Analysis). SiC x thin films with thicknesses between 1700 and 4500 Å and C/Si ratio between 0.2/1 and 1.25/1 were obtained in different deposition conditions. The results prove that thin films of amorphous SiC with well controlled properties can be produced using radiofrequency dual magnetron sputtering. [ABSTRACT FROM AUTHOR]

Objective: Epicardial fat is a measurable and modifiable risk factor that can serve as a novel and additional tool for cardiovascular risk stratification. Alterations in epicardial adipose tissue (EAT) biology, including increased fat thickness, inflammation and angiogenesis, have been described in (CAD) patients. Here, we proposed to measure EAT thickness and characterize inflammatory infiltrate and angiogenesis in epicardial adipose tissue in coronary artery disease (CAD) patients with and without chronic heart failure (CHF). We attempted also to identify clinical factors that may predict the development of CAD/cardiac ischemia. Methods: The paper studies the association between the cardiovascular risk factors (CVRFs) and morphological EAT hallmarks (EAT thickness, inflammation and angiogenesis) in patients with CAD. EAT thickness was done by using morphometry based on usual histological stains. Inflammatory cell infiltration and angiogenesis was investigated by immunohistochemical staining, using antibodies against CD68 and CD34 markers, and morphometry was done in 5 random 200+ power fields of EAT on right atrial appendages (RAA) samples subsequently obtained during cardiac surgery. Results: All CAD patients showed CVRFs such as age >50 years, arterial hypertension, smoking, DM, obesity and hyperlipidemia. EAT thickness, macrophage infiltration and angiogenesis of the EAT in the CAD patients (patients) with CHF was greater than that in CAD patients without CHF. Conclusion: EAT thickness, inflammation and angiogenesis is related by age, HTA, HL, obesity and diabetes in patients with CAD and CHF, suggesting that these CV RFs factors may have a role in promoting cardiac ischemia. [ABSTRACT FROM AUTHOR]

Objectives: CT and MRI scans of the shoulder can lead to the identification of incidental findings (IF), which can have a major impact on the further treatment of the patient. The aim of this retrospective study was to record the prevalence of IF, incidentalomas (IT) and malignant IT for CT and MRI examinations of the shoulder and to investigate the effect of patient characteristics on the statistical occurrence of IF, IT and malignant IT., Materials and Methods: A total of 903 shoulder examinations (415 CT, 488 MRI) were retrospectively analyzed for the presence of IF, subsequently categorized (harmless IF, IT requiring clarification, malignant IT) and analyzed regarding patient characteristics. The statistical analysis was carried out using independent t- and chi-square tests. A significance level of p < 0.05 was set., Results: Among the 903 patients evaluated (436 female, 467 male), 153 (16.9%) patients experienced IF (harmless IF: 101 (11.2%) patients, IT: 94 (10.4%), malignant IT: 4 (0.4%). The average age of the patients without IF and IT was significantly lower compared to the patients with IF and IT (p < 0.001). While IF occurred in 31.1% of the CT, IF was only detected in 4.9% of the MRI (p < 0.001)., Conclusion: IF have a high prevalence (16.9%), especially in CT examinations of the shoulder, which increases with age. The exact detection and initiation of appropriate therapy is of great clinical importance, as early detection of life-threatening diseases enables more effective treatment and a potential gain in health and lifespan., Competing Interests: None., (© 2024 The Authors.)